'Organ donations help us make a difference’

By Gordon Brown

12:01AM GMT 13 Jan 2008

This year will be the 60th anniversary of the National Health Service: a year to celebrate and thank all the staff who run our hospitals, clinics and GP practices; but also a year in which to renew the NHS for the 21st century, because I believe that only by renewal can we make the NHS even more relevant for future decades than it has been in the past.

That is why I spoke last week about our plans for change in the NHS. During 2008 we will take further steps to make the NHS a more personal service: as good at preventing illness as it is at treatment and cure, and far more willing to give more control directly into the hands of patients.

At the heart of this will be the expansion of screening and check-ups, giving all of us better information about our health and earlier access to treatment when we need it.

Later this year, Alan Johnson will set out radical plans to give patients with long-term or chronic conditions - ranging from asthma to heart disease - new rights to opt into a range of active patient programmes. This Patients' Prospectus will extend to millions of us a choice not just of when and where we are treated but, in consultation with our clinicians, of the type of treatment we would benefit from most.

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And through a new NHS constitution we will set out for the first time the rights to high-quality care and access to services; and also the responsibilities - to the NHS and to other patients - associated with that care.

So it is right in this anniversary year that - while sticking to the fundamental principle of the NHS that treatment should be free at the point of use and accessible to all - we also think radically about the future of healthcare and how we deliver it: confronting the challenges and being prepared to take the tough decisions needed to renew our NHS and improve the health of all of us.

And it is also right that in the year in which we celebrate the founding values of the NHS, that we each consider how we can make a difference to not only our own wellbeing but to the lives of others.

We know that transplant surgery is one of the great advances of medical science, and has saved the lives of thousands. Yet the organ donation on which it depends remains a difficult and sensitive issue on which feelings can be strong. Many of us will have friends and family members who have benefited from transplant surgery, or - tragically - who have endured the agonising wait for a life-saving organ that did not become available in time.

That is an avoidable human tragedy we can and must address. There are currently more than 8,000 people in the UK awaiting organ donation but only 3,000 transplants are carried out each year. Sadly, that means that more than 1,000 people die each year waiting for transplants. So we need to do more to ensure that organs are available to those who need them. This week, the Organ Donation Taskforce will report on how we can improve the management of transplant services and organ donations, and will set out a series of recommendations.

However, we may need to do more to encourage more of us to donate. In Britain we have 14.9 million people on the organ donor register - which is around 24 per cent of the population. In terms of actual donors (not just people willing to give, but those whose organs are actually used) we have a rate of about 13 donors per million in our population. This compares with about 22 per million in France, 25 per million in America and around 35 per million in Spain - the best in the world.

That is why I want to start a debate in this country about whether we should take steps to move towards a new system designed to enable far more of us to benefit from transplant surgery - one that better reflects survey findings that around 90 per cent of us are in favour of organ donation.

Sadly, only around a quarter of us have made specific advance arrangements by registering as potential organ donors. So about two-thirds of us - positive, but not registered as organ donors - are unable to help save the lives of others by organ donation when the circumstances arise.

A different consent system, more like the one used in Spain, could serve to increase donation levels significantly. Of course, any "opt-out" system would - in cases where the potential donor is not on the register - leave the final decision with the family: that is only right and proper.

But a system of this kind seems to have the potential to close the aching gap between the potential benefits of transplant surgery and the limits imposed by our current system of consent. A serious debate - involving the public most of all, but also bringing in professional views and those of religious leaders - is long overdue. To facilitate it, Alan Johnson and I have asked the Organ Donation Taskforce to begin consulting on the question of a move to a different consent system.

It is a sensitive issue, and one on which many different points of view need to be heard. I want to start a genuine debate, and I recognise that there will be legitimate concerns that need to be heard. Any system that moved towards a new kind of consent needs careful safeguards, and we should not move in advance of a real and thoughtful public debate involving faith communities, patients and families.

My hope is that 2008 will be a year in which we can address it with respect for different opinions and a real commitment to a more compassionate Britain - one that mobilises the best of our medical science and healthcare system, and our humanity too, to save thousands of lives that would otherwise be lost.